Since I was diagnosed with HIV a few years ago, I have had anal fissures from time to time. It's always in the same area of the anus, and it's usually the same ones reoccur. Fortunately, they are not painful. Are some people with HIV prone to have anal fissure, and if so, why is that? Before I was infected, I never had anal fissures. Is there any non-invasive treatment? Is there a supplement or something that may help to heal and prevent more fissures? What about the immune system? My CD4 count range is decent, but it can be better! If my CD4 count is higher, then could that help to heal and prevent more fissures? I want to be able to enjoy anal sex without worrying about this problem. Any information and/or suggestions will be greatly appreciated. Thank you!

Response from Dr. Henry

Anal fissures are difficult to clear up in many cases even in the general population-the anatomy of the anal area is fairly complicated. I recommend seeing an experience colon rectal surgeon to assess the extent of the fissure, make sure there is no fistula, and make treatment recommendations. Topical nitroglycerin seems to help some patients heal up the area. Trauma/stretching from anal sex can be a factor in development of anal fissures and recurrences. See the wikipedia link below for background information:

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